Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02591 | Date 24/07/2019 |
| Token No | SM/18-19/6583 21/09/2019 | Serial | 002 |
| Patient Name | Mrs. KALPANA SINGH | Contact No | 8961138718 |
| Address | 45 AKHRABATI LANE | Age | 63 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||